DIỄN TIẾN ĐÁP ỨNG ĐIỀU TRỊ ARV TRONG 6 THÁNG ĐẦU Ở BỆNH NHÂN NHIỄM HIVAIDS TẠI PHÒNG KHÁM NGOẠI TRÚ BỆNH VIỆN BỆNH NHIỆT ĐỚI

Abstract

Background: ARV improves prognosis and reduces HIV transmission, but its effectiveness depends on multiple factors. In Vietnam, first-line regimens with DTG are widely used, but early treatment outcome data remain limited. Objectives: (1) To describe the treatment response in HIV/AIDS patients during the first six months of ART at the Hospital for Tropical Diseases, and (2) To determine the proportion and associated factors of patients achieving undetectable HIV RNA levels after six months of treatment. Methods: A prospective cross-sectional study on 76 newly diagnosed HIV patients initiating ART at the Hospital for Tropical Diseases (10/2023–7/2024). Clinical, immunological, HIV RNA, biochemical, and treatment adherence data were collected and analyzed using SPSS 26.0. McNemar's test assessed immune and clinical changes after six months. Logistic regression identified factors associated with undetectable HIV RNA levels. Results: The proportion of patients in clinical stage 1 increased from 35.5% to 88.2% (p < 0.01), the median CD4⁺ count increased from 101 to 240 cells/mm³ (p = 0.001), and the proportion with HIV RNA ≤ 50 copies/mL reached 71%. Good treatment adherence (OR = 19.02) and higher BMI (OR = 1.29) were independently associated with the likelihood of achieving an undetectable HIV RNA level. After 6 months, the proportion of underweight patients decreased from 34.1% to 18.4% (p = 0.04), the median hemoglobin increased from 12.9 to 13.9 g/dL (p = 0.001), and creatinine clearance decreased from 96.5 to 88.0 mL/min (p = 0.048). Conclusions: After six months of ART, most patients showed significant improvements in clinical, immunological, and virological parameters. Treatment adherence and BMI were key factors associated with better virological outcomes.